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Background The recent Ebola Virus Disease (EVD) epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to) any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS) regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hospital based cross sectional study involving 101 HCWs from two facilities in Kumasi, Ghana to assess the level of preparedness of HCWs to respond to any possible EVD. Methods We administered a face-to-face questionnaire using an adapted WHO (2015) and CDC (2014) Checklist for Ebola Preparedness and assessed overall knowledge gaps, and preparedness of the Ghanaian HCWs in selected health facilities of the Ashanti Region of Ghana from October to December 2015. Results A total 92 (91.09%) HCWs indicated they were not adequately trained to handle an EVD suspected case. Only 25.74% (n = 26) considered their facilities sufficiently equipped to handle and manage EVD patients. When asked which disinfectant to use after attending to and caring for a suspected patient with EVD, only 8.91% (n = 9) could correctly identify the right disinfectant (χ2 = 28.52, p = 0.001). Conclusion Our study demonstrates poor knowledge and ill preparedness and unwillingness of many HCWs to attend to EVD. Beyond knowledge acquisition, there is the need for more training from time to time to fully prepare HCWs to handle any possible EVD case.

The inferior vena cava is the most commonly injured abdominal vessel and accounts for about 25% of abdominal vascular injuries. Despite improved preoperative care and operative techniques, the mortality rates for the inferior vena cava injuries are still high due to delayed presentation, inadequate or delayed fluid resuscitation, difficulty of diagnosis and technical problems in repair. A case of the inferior vena cava injury encountered after abdominal stabinjury with about 4cm vertical tear of infrarenal vena cava, survived due to immediate transportation, appropriate and successful perioperative fluid and blood resuscitation, prompt surgical management with a team approach and critical post-operative surgical management.Keywords: The inferior vena cava (IVC), stab wound, venorrhaphy, haemoperitoneum

Introduction:Komfo Anokye Teaching Hospital Emergency Department (KATH ED) is a tertiary referral center in Ghana. Anecdotally, patients seeking care at KATH ED do not actively participate in research initiatives.Aim:To find out why patients presenting to KATH ED do not enroll in research studies that are conducted in the department.Methods:The study was a cross-sectional survey of patients presenting to the ED for one month in June 2017. A semi-structured questionnaire was presented to patients presenting to KATH ED from 8:00-20:00 each day. Patients who were interviewed were all patients presenting to the ED for care, including those who had refused to enroll in the ongoing ACESO study. Patients had to be conscious, alert, and with conditions that did not require immediate management.Results:35% of the interviewees (91/260) had been approached to enroll in research studies at some point in the past. 13.5% had refused to enroll in a research study. 45.7% of those who refused to enroll admitted that they were afraid to enroll in a study; 28.6% had inadequate information and 22.9% perceived enrolling in a study would delay their treatment. The Akan language (73%) was most commonly used by research assistants then English (26%), and finally Hausa (1%) to interact with patients. There was a significant association between educational background and explaining a study to a patient before they enrolled. Males were more willing to enroll in an ongoing study compared to females. All age groups correlated significantly with being approached to enroll in a research study and similarly all age groups also correlated with refusing to enroll in a research studyDiscussion:Patients are paramount to hospital research. Efforts must be made to ensure that patients concerns and needs are addressed to ensure increasing participation.

We performed a nested convenience sample survey of harmful alcohol use among injured patients aged 18 years and older treated in the Komfo Anokye Teaching Hospital (Kumasi, Ghana) emergency department (ED). Data from the Alcohol Use Disorder Identification Test, alcohol breath or saliva tests, patient demographics and injury characteristics were collected from an administered survey and medical chart review. A total of 403 subjects were surveyed, and 107 (27%; 95% CI 22 to 31) reported harmful alcohol use. High rates of harmful alcohol use were found among males (35%), acutely alcohol-positive subjects (55%), drivers (32%), pedestrians (35%) and assault victims (43%). A substantial proportion of injured patients reported harmful alcohol use. The data obtained support routine screening of injured patients presenting to Ghanaian EDs for harmful alcohol use.

Background: Ghana has an estimated HIV prevalence of 1.4%, but the HIV prevalence of patients presenting at emergency departments in Ghana is not well documented in published literature. This study evaluated the prevalence of HIV infection at the Accident & Emergency Department, Komfo Anokye Teaching Hospital (KATH A&E), Kumasi, Ghana.Methods: A descriptive cross-sectional survey was carried out on patients aged 18 and above presenting to KATH A&E. An opt-in testing approach was used; consenting patients were screened for HIV using rapid HIV finger-stick testing with HIV 1-2 STAT-PAK. Sero-positivity was confirmed by OraQuick HIV 1-2 test. Data was analysed using multivariate logistic regression.Results: 1125 patients presenting at the KATH A&E during the study period were offered the Rapid HIV test. 667 of these patients consented to have the test. HIV prevalence was 13.5% (90/667). 53 females (58.9%) were HIV positive compared to 37 males (41.1%). The age group 30-50 years had the highest risk of being HIV-positive. Other socio-demographic variables such as educational level and occupation were significantly associated with HIV-infection (Pvalue = 0.001 at 95% CI).Conclusion: This study shows that emergency department HIV testing in Ghana is feasible. The prevalence of HIV sero-positive patients presenting at KATH A&E was tenfold higher than national estimates. We conclude that this study showed a high prevalence among patients seeking emergency care in our setting. Testing in the emergency department could lead to early detection of HIV-infected patients for linkage to care.Keywords: HIV Infections; HIV Screening; Prevalence, Diagnosis, Emergency Department

Introduction In a busy emergency department (ED), missing patient medical records is a common complaint to contend with. Electronic medical records (EMR) may be one useful way of ensuring patient record integrity and confidentiality. KATH ED sees 28,000 patients a year and integrity of patient records is a major challenge. This study sought to improve the integrity of medical records within the ED and efficiency of patient flow within the ED Methods Regular panel meetings of emergency physicians, IT specialists and biostatisticians were held from February, 2012 to February, 2013. Open source software, Openemr was adapted in the creation of electronic medical records for the ED of KATH in February, 2012. Changes were made to the software included registration and patient search, triage board, doctor's notes whiteboard to reflect the pattern of practice in KATH ED. Results The EMR allows registration, triage and the entire medical records to be stored on patients. 12,000 Patient demographics have been migrated on to the EMR. Emergency physicians and charge nurses are able to monitor patient flow in the ED. Conclusion Open source medical records may be the most appropriate and cost-effective software to adapt for keeping patient records electronically in a low resource setting. Further studies need to be conducted to demonstrate how EMR may affect the pace of work in the ED.

Introduction Motor vehicle crashes are a major cause of morbidity and mortality in developing countries. Injuries resulting from fire arms were the second leading cause of death in the US in 2003. In Ghana, motor vehicle crashes (MVC) are a common cause of injury and mortality whiles firearm related injuries (FAI) have not featured highly. However, with increase in commercial and industrial activities in Ghana, firearm related injuries have been on the increase. This study seeks to compare FAI and MVC admissions in the ED. Methods A retrospective cross-sectional review of all admissions resulting from FAI and MVC from May, 2009 to December, 2012. The trends in rate of admissions per month and yearly was assessed and compared. Analysis was done using Stata 11.0 Results There were 409 FAI and 11,195 MVC admissions over years. Men were more involved in both MVC and FAI than women. FAI and MVC admissions occurred mostly between June and August, and November and December each year. FAI admissions have increased by seven-fold in four years whereas MVC admissions increased by 1.8 in 2011 and declined by 11.5% by the end of 2012. In 2009, FAI constituted 0.8% of all injuries in the ED in 2009 and at the end of 2012 contributed 5% to the injury pool. Conclusion MVC continue to be a major cause of injury admissions, however the rising FAI admissions cannot be overlooked. FAI may have gained public health significance in Ghana and requires attention as MVC.